Tb

Possibly Resistant Tuberculosis Treatment

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Possibly Resistant Tuberculosis Treatment, Possibly Resistant Tb Treatment

  • Indications
  1. Isoniazid Resistance >4% in patient's community
  2. Human Immunodeficiency Virus (HIV)
  3. Prior Tuberculosis exposure
  • Precautions
  1. This protocol is from 2003 without available new guidance to use for update as of 2016 review
  2. Multi-drug resistance requires expert local opinion for guidance
  • Management
  1. Initial: Four drug therapy for 2 months
    1. Isoniazid
    2. Rifampin
    3. Pyrazinamide
    4. Ethambutol or Streptomycin
  2. Subsequent Dosing
    1. If Isoniazid susceptible, treat for 6 months
      1. Isoniazid
      2. Rifampin
    2. If Isoniazid resistant THEN
      1. Protocol A: Treat for 6 months
        1. Rifampin
        2. Pyrazinamide AND
        3. Ethambutol OR Streptomycin
      2. Protocol B: Treat for 12 months
        1. Rifampin
        2. Ethambutol
    3. If Extrapulmonary Tuberculosis, treat for >9 months
      1. Disseminated tuberculosis
      2. Osteomyelitis
      3. Meningitis
      4. Human Immunodeficiency Virus (HIV)
    4. If TuberculosisMeningitis
      1. Continue Pyrazinamide for full course